Provider Demographics
NPI:1730662230
Name:SIMPSON, DEBRA LAVONNE
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LAVONNE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27522 KINGSLAND PLACE LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1576
Mailing Address - Country:US
Mailing Address - Phone:773-530-6618
Mailing Address - Fax:
Practice Address - Street 1:27522 KINGSLAND PLACE LN
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1576
Practice Address - Country:US
Practice Address - Phone:773-530-6618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX711440163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics